The temporal dynamics of Plasmodium species infection after artemisinin-based combination therapy (ACT) among asymptomatic children in the Hohoe municipality, Ghana

The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy formulation and the implementation of appropriate control measures. In this study, the prevalence rate and the dynamics of Plasmodium...

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Published in:	Malaria journal Vol. 22; no. 1; pp. 271 - 12
Main Authors:	Ansah, Felix, Nyame, Kwamina, Laryea, Rukaya, Owusu, Richard, Amon, Denick, Boyetey, Mark-Jefferson Buer, Ayeke, Dzidzor, Razak, Nasibatu, Kornu, Victor E, Ashitei, Sarah, Owusu-Appiah, Caleb, Chirawurah, Jersley D, Abugri, James, Aniweh, Yaw, Opoku, Nicholas, Sutherland, Colin J, Binka, Fred N, Kweku, Margaret, Awandare, Gordon A, Dinko, Bismarck
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 14-09-2023 BioMed Central BMC
Subjects:	Amodiaquine Analysis Artemisinin Artemisinin-based combination therapy (ACT) Artemisinins - therapeutic use Artesunate Asymptomatic Asymptomatic malaria Child Children Combination therapy Comparative analysis Control Cross-sectional studies Deoxyribonucleic acid DNA Genomics Genotype Ghana - epidemiology Health aspects Human diseases Humans Identification and classification Infection Malaria Malaria - drug therapy Malaria - epidemiology Malaria, Falciparum - drug therapy Malaria, Falciparum - epidemiology Microscopy Nucleic Acids Nucleotide sequence Parasite clearance Parasites Parasitic diseases PCR Plasmodium Plasmodium falciparum Plasmodium malariae Plasmodium species Polymerase chain reaction Prevalence rate Prevention Risk factors Vector-borne diseases Ghana England United Kingdom > UK Nigeria Africa Plasmodium species Prevalence rate Parasite clearance Asymptomatic malaria Artemisinin-based combination therapy (ACT)
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Summary:	The routine surveillance of asymptomatic malaria using nucleic acid-based amplification tests is essential in obtaining reliable data that would inform malaria policy formulation and the implementation of appropriate control measures. In this study, the prevalence rate and the dynamics of Plasmodium species among asymptomatic children (n = 1697) under 5 years from 30 communities within the Hohoe municipality in Ghana were determined. The observed prevalence of Plasmodium parasite infection by polymerase chain reaction (PCR) was 33.6% (571/1697), which was significantly higher compared to that obtained by microscopy [26.6% (451/1697)] (P < 0.0001). Based on species-specific analysis by nested PCR, Plasmodium falciparum infection [33.6% (570/1697)] was dominant, with Plasmodium malariae, Plasmodium ovale and Plasmodium vivax infections accounting for 0.1% (1/1697), 0.0% (0/1697), and 0.0% (0/1697), respectively. The prevalence of P. falciparum infection among the 30 communities ranged from 0.0 to 82.5%. Following artesunate-amodiaquine (AS + AQ, 25 mg/kg) treatment of a sub-population of the participants (n = 184), there was a substantial reduction in Plasmodium parasite prevalence by 100% and 79.2% on day 7 based on microscopy and nested PCR analysis, respectively. However, there was an increase in parasite prevalence from day 14 to day 42, with a subsequent decline on day 70 by both microscopy and nested PCR. For parasite clearance rate analysis, we found a significant proportion of the participants harbouring residual Plasmodium parasites or parasite genomic DNA on day 1 [65.0% (13/20)], day 2 [65.0% (13/20)] and day 3 [60.0% (12/20)] after initiating treatment. Of note, gametocyte carriage among participants was low before and after treatment. Taken together, the results indicate that a significant number of individuals could harbour residual Plasmodium parasites or parasite genomic DNA after treatment. The study demonstrates the importance of routine surveillance of asymptomatic malaria using sensitive nucleic acid-based amplification techniques.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1475-2875 1475-2875
DOI:	10.1186/s12936-023-04712-1